Warfarin prevalence, indications for use and haemorrhagic events

dc.contributor.authorQuirke, William
dc.contributor.authorCahill, Mary R.
dc.contributor.authorPerera, Kanthi
dc.contributor.authorSargent, Jeremy
dc.contributor.authorConway, Jane
dc.date.accessioned2011-11-28T17:07:05Z
dc.date.available2011-11-28T17:07:05Z
dc.date.issued2007-03
dc.date.updated2011-11-28T16:38:26Z
dc.description.abstractWarfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates.Warfarin, the standard oral anticoagulant drug used in Ireland, is a widely prescribed medication, particularly in the elderly. A HSE Mid-Western Area wide audit was undertaken over a 12-month period to examine the prevalence and indications for warfarin use and haemorrhagic complications associated with the drug. Every patient receiving warfarin therapy over a 13-week period was included (2564). The age standardised rate varied from 0.09% of 35-39 year olds to 6.1% of 80-84 year olds. Atrial fibrillation was the most common indication (54%) in patients attending the Mid-Western Regional Hospital anticoagulation clinic. The annual cumulative incidence of adverse haemorrhagic events in patients with a recorded INR > or = 5.0 episode was 16.6%. The incidence of major and minor haemorrhagic events per INR > or = 5.0 episode was 1.3% and 15.3% respectively. The most common sites of haemorrhage were genitourinary (39%) and gastrointestinal (27%). No fatal or intracranial haemorrhage relating to episodes of over-anticoagulation were reported during the audit period. The most frequent reason for over-anticoagulation was drug interaction (43%). In 74% of patients, the elevated INR was reversed by omitting or reducing warfarin dose. In 17% of cases, vitamin K was administered. Only 3% of incidents were treated with fresh frozen plasma or prothrombin complex concentrates.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationOuirke, W.;Cahill, M.R.;Perera, K.;Sargent, J.;Conway, J. (2007) 'Warfarin prevalence, indications for use and haemorrhagic events'. Irish Medical Journal, 100 (3):402-404.en
dc.identifier.endpage404en
dc.identifier.issn0332-3102
dc.identifier.issued3en
dc.identifier.journaltitleIrish Medical Journalen
dc.identifier.startpage402en
dc.identifier.urihttps://hdl.handle.net/10468/465
dc.identifier.volume100en
dc.language.isoenen
dc.publisherIrish Medical Organizationen
dc.relation.urihttp://www.imj.ie//IMJPage_0_1.aspx?issueid=311#Original%20Papers
dc.rights© Irish Medical Journal 2007en
dc.subjectWarfarinen
dc.subject.lcshHemorrhageen
dc.subject.lcshAnticoagulants (Medicine)en
dc.titleWarfarin prevalence, indications for use and haemorrhagic eventsen
dc.typeArticle (peer-reviewed)en
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